Vital statistical department, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China.
Shanghai Ji Ai Genetics and IVF Institute, Shanghai, People's Republic of China.
Fertil Steril. 2018 May;109(5):849-856. doi: 10.1016/j.fertnstert.2018.01.012.
To evaluate the impact of assisted reproductive technology (ART) on the offspring of Chinese population.
Retrospective, data-linkage cohort.
Not applicable.
PATIENT(S): Live births resulting from ART or natural conception.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Birth defects coded according to ICD-10.
RESULT(S): Births after ART were more likely to be female and multiple births, especially after intracytoplasmic sperm injection (ICSI). ART was associated with a significantly increased risk of birth defects, especially, among singleton births, a significantly increased risk in fresh-embryo cycles after in vitro fertilization (IVF) and frozen-embryo cycles after ICSI. Associations between ART and multiple defects, between ART and gastrointestinal malformation, genital organs malformation, and musculoskeletal malformation among singleton births, and between ART and cardiac septa malformation among multiple births were observed.
CONCLUSION(S): This study suggests that ART increases the risk of birth defects. Subgroup analyses indicate higher risk for both fresh and frozen embryos, although nonsignificantly for frozen embryos after IVF and for fresh embryos were presented with low power. Larger sample size research is needed to clarify effects from fresh- or frozen-embryo cycles after IVF and ICSI.
评估辅助生殖技术（ART）对中国人群后代的影响。
回顾性、数据链接队列研究。
不适用。
ART 或自然受孕的活产儿。
无。
根据国际疾病分类第 10 版（ICD-10）编码的出生缺陷。
ART 后出生的婴儿更有可能是女性和多胎，尤其是在卵胞浆内单精子注射（ICSI）之后。ART 与出生缺陷的风险显著增加相关，尤其是在体外受精（IVF）后的新鲜胚胎周期和 ICSI 后的冷冻胚胎周期中，单胎出生的风险显著增加。ART 与多胎出生的多发畸形、ART 与胃肠道畸形、生殖器官畸形和肌肉骨骼畸形以及 ART 与多胎的心脏间隔畸形之间存在关联。
本研究表明，ART 增加了出生缺陷的风险。亚组分析表明，新鲜胚胎和冷冻胚胎的风险均较高，尽管 IVF 后的冷冻胚胎和新鲜胚胎的风险无统计学意义，但研究结果显示新鲜胚胎的效能较低。需要更大的样本量研究来阐明 IVF 和 ICSI 后新鲜或冷冻胚胎周期的影响。
